Healthcare Provider Details

I. General information

NPI: 1770091357
Provider Name (Legal Business Name): LNH ONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BARNES ST
LONOKE AR
72086-2003
US

IV. Provider business mailing address

455 E PACES FERRY RD NE STE 302
ATLANTA GA
30305-3320
US

V. Phone/Fax

Practice location:
  • Phone: 501-676-3700
  • Fax: 501-676-3701
Mailing address:
  • Phone: 404-386-9607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateAR

VIII. Authorized Official

Name: CHRISTOPHER BROGDON
Title or Position: MANAGER
Credential:
Phone: 404-386-9607